Communication with relatives on prognosis of critically ill patients
Main Article Content
Abstract
Most patients admitted to the intensive care unit are unable to participate in decisions relating to their care. Therefore, physicians have to inform relatives on the condition of the patient, his evolution and the estimated prognosis. Numerous studies have shown that relatives commonly have inaccurate expectations of the patient’s prognosis, due to either misunderstanding of oral information by the physicians and/or overly optimistic beliefs. This may lead to undue prolongation of an ICU stay in the case of a poor prognosis. Several methods have been proposed in order to align relatives with the estimation of the patient’s prognosis by the physicians. The use of visual tools, added to oral information seems beneficial. Moreover, communication with relatives on the prognosis has to convey support and empathy.
Keywords:
Critically ill patients, prognosis, relatives, visual aid
Article Details
How to Cite
BEURET, Pascal; VEISLINGER, Gabrielle.
Communication with relatives on prognosis of critically ill patients.
Medical Research Archives, [S.l.], v. 10, n. 1, jan. 2022.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/2657>. Date accessed: 20 apr. 2024.
doi: https://doi.org/10.18103/mra.v10i1.2657.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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26. Smith AK, White DB, Arnold RM. Uncertainty – the other side of prognosis. N Engl J Med. 2013; 368: 2448-2450.
27. Pochard F, Azoulay E, Chevret S, Lemaire F, Hubert P, Canoui P, et al. Symptoms of anxiety and depression in family members of intensive care unit patients: ethical hypothesis regarding decision-making capacity. Crit Care Med. 201; 29: 1893-1897.
28. McAdam JL, Dracup KA, White DB, Fontaine DK, Puntillo KA. Symptom experiences of family members of intensive care unit patients at high risk for dying. Crit Care Med. 2010; 38: 1078-1085.
29. Veislinger-Burelli G, Vincent A, Mallard J, Meffre S, Maarek A, Bonnet A, et al. Impact of a visual support dedicated to prognosis on symptoms of stress of ICU family members: a before-and-after implementation study. Crit Care Explor. 2021; 3(7): e0483.
30. Schenker Y, White DB, Crowley-Matoka M, Dohan D, Tiver GA, Arnold RM. “It hurts to know…and it helps”: exploring how surrogates in the ICU cope with prognostic information. J Palliat Med. 2013; 16(3): 243-249.
31. Quinn T, Moskowitz J, Khan MW, Shutter L, Goldberg R, Col N, et al. What families need and physicians deliver: contrasting communication preferences between surrogate decision-makers and physicians during outcome prognostication in critically ill TBI patients. Neuro Crit Care. 2017; 27(2): 154-162.
2. Apatira L, Boyd EA, Malvar G, Evans LR, Luce JM, Lo B, et al. Hope, truth, and preparing for death: perspectives of surrogate decision makers. Ann Intern Med. 2008; 149: 861-868.
3. Fassier T, Darmon M, Laplace C, Chevret S, Schlemmer B, Pochard F, et al. One-day quantitative cross-sectional study of family information time in 90 Intensive care units in France. Crit Care Med. 2007, 35(1): 177-183.
4. White DB, Engelberg RA, Wenrich MD, Lo B, Curtis JR. The language of prognostication in Intensive Care Units. Med Decis Making. 2010; 30(1): 76-83.
5. Oppenheim IM, Lee EM, Vasher ST, Zaeh SE, Hart JL, Turnbull AE. Effect of intensivist communication in a simulated setting on interpretation of prognosis among family members of patients at high risk of intensive care unit admission. JAMA Network Open. 2020; 3(4): e201945.
6. Azoulay E, Chevret S, Leleu G, Pochard F, Barboteu M, AdrieC, et al. Half the families of intensive care unit patients experience inadequate communication with physicians. Crit Care Med. 2000 ; 28(8) : 3044-3049.
7. Cox CE, Martinu T, Sathy SJ, Clay AS, Chia J, Gray AL, et al. Expectations and outcomes of prolonged mechanical ventilation. Crit Care Med. 2009; 37(11): 2888-2894.
8. Chiarchiaro J, Buddadhumaruk P, Arnold RM, White DB. Quality of communication in the ICU and surrogate’s understanding of prognosis. Crit Care Med. 2015; 43: 542-548.
9. Burelli G, Berthelier C, Vanacker H, Descaillot L, Philippon-Jouve B, Fabre X, et al. Impact of a visual aid on discordance between physicians and family members about prognosis of critically ill patients. Anaesth Crit Care Pain Med. 2018; 37(3): 207-210.
10. Kiker WA, Voumard RR, Andrews LI, Holloway RG, Brumback LC, Engelberg RA, et al. Assessment of discordance between physicians and family members regarding prognosis in patients with severe acute brain injury. JAMA Network Open. 2021; 4(10): e2128991.
11. White DB, Ernecoff N, Buddadhumaruk P, Hong S, Weissfeld L, Curtis JR, et al. Prevalence of and factors related to discordance about prognosis between physicians and surrogate decision makers of critically ill patients. JAMA. 2016; 315(19): 2086-2094.
12. Lee Char SJ, Evans LR, Malvar GL, White DB. A randomized trial of two methods to disclose prognosis to surrogate decision makers in intensive care units. Am J Respir Crit Care Med. 2010; 182: 905-909.
13. Zier LS, Sottile PD, Hong SY, Weissfield LA, White DB. Surrogate decision makers’ interpretation of prognostic information: a mixed-methods study. Ann Intern Med. 2012; 156(5): 360-366.
14. White DB, Carson S, Anderson W, Steingrub J, Bird G, Curtis JR, et al. A multicenter study of the causes and consequences of optimistic expectations about prognosis by surrogate decision-makers in ICUs. Crit Care Med. 2019; 47: 1184-1193.
15. Warrillow S, Farley KJ, Jones D. Ten practical strategies for effective communication with relatives of ICU patients. Intensive Care Med. 2015; 41: 2173-2176.
16. Azoulay E, Forel JM, Vinatier I, Truillet R, Renault A, Valade S, et al. Questions to improve family-staff communication in the ICU: a randomized controlled trial. Intensive Care Med. 2018; 44: 1879-1887.
17. Paling J. Strategies to help patients understand risks. BMJ. 2003; 327(7417):745-748.
18. Thomson R, Edwards A, Grey J. Risk communication in the clinical consultation. Clin Med. 2005; 5: 465-469.
19. Chapman AR, Litton E, Chamberlain J, Ho KM. The effect of prognostic data presentation format on perceived risk among surrogate decision makers of critically ill patients: a randomized comparative trial. Journal of Critical Care. 2015; 30: 231-235.
20. Schillinger D, Piette J, Grumbach K, Wang F, Wilson C, Daher C, et al. Closing the loop: physician communication with diabetic patients who have low health literacy. Arch Intern Med. 2003; 163: 83-90.
21. Azoulay E, Pochard F, Chevret S, Jourdain M, Bornstain C, Wernet A, et al.Impact of a family information leaflet on effectiveness of information provided to family members of intensive care unit patients. Am J Respir Crit Care Med. 2002; 165: 438-442.
22. Mistraletti G, Umbrello M, Mantovani ES, Moroni B, Formenti P, Spanu P, et al. A family information brochure and dedicated website to improve the ICU experience for patients’ relatives: an Italian multicenter before-and-after study. Intensive Care Med. 2017; 43(1): 69-79.
23. Stacey D, Légaré F, Lewis K, Barry MJ, Bennett CL, Eden KB, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews. 2017, Issue 4, Art.No.: CD001431.
24. Cox CE, Lewis CL, Hanson LC, Hough CL, Kahn JM, White DB, et al. Development and pilot testing of a decision aid for surrogates of patients with prolonged mechanical ventilation. Crit Care Med. 2012; 40: 2327-2334.
25. Cox CE, White DB, Hough CL, Jones DM, Kahn JM, Olsen MK, et al. Effects of a personalized web-based decision aid for surrogate decision makers of patients with prolonged mechanical ventilation. A randomized clinical trial. Ann Intern Med. 2019; 170: 285-297.
26. Smith AK, White DB, Arnold RM. Uncertainty – the other side of prognosis. N Engl J Med. 2013; 368: 2448-2450.
27. Pochard F, Azoulay E, Chevret S, Lemaire F, Hubert P, Canoui P, et al. Symptoms of anxiety and depression in family members of intensive care unit patients: ethical hypothesis regarding decision-making capacity. Crit Care Med. 201; 29: 1893-1897.
28. McAdam JL, Dracup KA, White DB, Fontaine DK, Puntillo KA. Symptom experiences of family members of intensive care unit patients at high risk for dying. Crit Care Med. 2010; 38: 1078-1085.
29. Veislinger-Burelli G, Vincent A, Mallard J, Meffre S, Maarek A, Bonnet A, et al. Impact of a visual support dedicated to prognosis on symptoms of stress of ICU family members: a before-and-after implementation study. Crit Care Explor. 2021; 3(7): e0483.
30. Schenker Y, White DB, Crowley-Matoka M, Dohan D, Tiver GA, Arnold RM. “It hurts to know…and it helps”: exploring how surrogates in the ICU cope with prognostic information. J Palliat Med. 2013; 16(3): 243-249.
31. Quinn T, Moskowitz J, Khan MW, Shutter L, Goldberg R, Col N, et al. What families need and physicians deliver: contrasting communication preferences between surrogate decision-makers and physicians during outcome prognostication in critically ill TBI patients. Neuro Crit Care. 2017; 27(2): 154-162.